• Journal of Preventive Medicine and Public Health
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• v.45 no.2
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• pp.105-112
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• 2012

Objectives: Cigarette smoking is a modifiable risk factor for cardiovascular disease. Bilirubin is a potent antioxidant and its concentration decreases in smokers. However, studies about the association between cigarette smoking and bilirubin are scarce and most are limited to total bilirubin. Additionally, bilirubin is highly related to hemoglobin. Therefore, this study evaluates the association between bilirubin subtypes and cigarette smoking in healthy Korean men independently of hemoglobin. Methods: This study included 48 040 Korean men aged 30 to 87 years who visited the Korea Medical Institute for routine health examinations from January to December, 2007. The association of smoking with total, direct, and indirect bilirubin was assessed by logistic regression analysis taking into consideration differences in subjects and smoking characteristics. Results: Current smokers had lower bilirubin concentrations than never-smokers and ex-smokers. Smoking amount and duration were inversely significantly associated with total, direct, and indirect bilirubin. In a multivariable adjusted model, compared to never-smokers, the odds ratios (ORs) and 95% confidence intervals (CIs) of current smokers with the highest number of pack-years were 1.7 (1.6 to 1.9) for total, 1.5 (1.4 to 1.6) for direct, and 1.7 (1.6 to 1.9) for indirect bilirubin. After further adjustment for hemoglobin, this association became stronger (OR [95% CI], 2.1 [1.9 to 2.2] for total; 1.9 [1.8 to 2.0] for direct; 2.0 [1.9 to 2.2] for indirect bilirubin). Conclusions: In this study, bilirubin subtypes are inversely associated with smoking status, smoking amount, and smoking duration in healthy Korean men independently of hemoglobin. Further studies are needed to investigate this association in healthy Korean women.

• Korean Journal of Veterinary Research
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• v.14 no.1
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• pp.23-27
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• 1974

Concentration of total protein, bilirubin, sodium and potassium in blood sera, and thymol turbidity of race horses, 78 males and 57 females aging from 2 to 5 years, were estimated. The results obtained were as follows: 1. Serum of race horses was low in protein concentrations as mean values of $5.48{\pm}0.77$ g/100ml. 2. Serum bilirubin was in normal range as mean values of total bilirubin, direct bilirubin and indirect bilirubin were $1.05{\pm}0.57$, $0.12{\pm}0.05$ and $0.93{\pm}0.58$ mg/100ml, respectively. 3. Mean value of serum thymol turbidity was $1.41{\pm}0.72$ S-H unit. 4. Mean values of serum sodium and potassium of race horses from Australia were $143{\pm}8.7$ and $3.85{\pm}0.53$ mEq/liter, respectively, and mean values of serum sodium and patassium of race horses from Japan were $142{\pm}9.4$ and $3.58{\pm}0.60$ mEq/liter, respectively.

• Journal of Society of Preventive Korean Medicine
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• v.3 no.1
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• pp.36-36
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• 1999

From January 1994 to April 1997, there was 15 survivals who was admitted to the department of internal medicine, Wonkwang Oriental Medicine' Hospital in Cheun-ju, after ingestion of paraquat, and treated with Oriental and western medicine therapy. For the patients, I investigated clinical symptoms, gastroduodenoscopy, intake by oral and parenteral route, and output by urine and stool, serum ALP, AST. ALT, Bilirubin, BUN, Creatinine level and urine analysis. On admission day, the LFT level was as follows. The serum mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin was 10.05${\pm}$2.75 KAU, 66.67${\pm}$9.88 IU／L, 43.80${\pm}$7.74 IU／L, 1.89${\pm}$1.22 ㎎／dl and 1.10${\pm}$1.14 ㎎／dl respectively. After that day, administered Gamdutang and checked the mean LFT level regullary. Until the 3rd day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was 11.0l${\pm}$3.16 KAU, 56.47${\pm}$7.19 IU／L, 59.00${\pm}$7.57 IU／L, 2.54${\pm}$1.78 ㎎／dl, 1.64${\pm}$1.59 ㎎／dl respectively. From 4th day to 7th day, the mean ALP; AST, ALT, Total Bilirubin and Direct Bilirubin level was 12.51${\pm}$3.49 KAU, 77.85${\pm}$7.17 IU／L, 58.00${\pm}$9.09 IU／L, 2.54${\pm}$1.97 ㎎／dl, and 1.80${\pm}$1.81 ㎎／dl respectively. From 8th day to 10th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was 12.43${\pm}$3.14 KAU, 41.13${\pm}$6.49 IU／L, 50.40${\pm}$7.17 IU／L, 1.66${\pm}$1.90 ㎎／dl and 1.14${\pm}$1.50 ㎎／dl respectively. From 11th day to 14th day, the mean ALP, AST, ALT, Total Bilirubin and Direct Bilirubin level was 12.30${\pm}$3.25 KAU, 31.07${\pm}$3.85 IU／L, 43.33${\pm}$5.49 IU／L, 1.62${\pm}$1.95 ㎎／dl, 1.17${\pm}$1.71 ㎎／dl respectvely. On admission day, the mean RFT level as follows. Serum BUN and Creatinine level was 28.73${\pm}$5.19 ㎎／dl and 1.82${\pm}$1.27 ㎎／dl respectively. After that day, administered Gamdutang and checked the mean RFT level regullary. Until the 3rd day, the mean BUN and Creatinine level was 32.12${\pm}$5.65 ㎎／dl and 2.31${\pm}$0.45 ㎎／dl respectively. From 4th day to 7th day, the mean BUN and Creatinine level was 31.07${\pm}$5.47 ㎎／dl and 1.92${\pm}$0.79 ㎎／dl respectively. From 7th day to 10th day, the mean BUN and Creatinine level was 17.47${\pm}$3.57 ㎎／dl and 1.33${\pm}$0.59 ㎎／dl respectively. From 11th day to 14th day, the mean BUN and Creatinine level was 11,93${\pm}$3.16 ㎎／dl, 1.27${\pm}$0.38 ㎎／dl respectively.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.2
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• pp.155-163
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• 2018

Bilirubin has an anti-inflammatory effect as an endogenous antioxidant and has been reported to be inversely correlated with hypertension, diabetes, metabolic syndrome, and insulin resistance. On the other hand, there is a lack of research evaluating the association between bilirubin and metabolic syndrome compared to liver-specific indicators. This study examined the association between the total bilirubin and metabolic syndrome prevalence in Korean adults who underwent health screening compared to ALT and GGT. This cross sectional study included 22,568 adult males and females aged 20 years or older who underwent a health examination at the General Hospital of Gyeonggi Province from March 2015 to February 2018. Metabolic syndrome was diagnosed based on the American Heart Association/National Heart, Lung, and Blood Institute (AHA/NHLBI) guidelines. In both genders, the metabolic syndrome diagnosed group had higher liver enzymes, and the total bilirubin and direct bilirubin were lower than those without the metabolic syndrome risk factors. The serum total bilirubin showed a weak inverse correlation with abdominal obesity (r=-0.066 vs r=-0.055) and triglyceride (r=-0.127 vs r=-0.136) in both males and females, which is weaker than ALT and GGT The data were statistically significant. In addition, total bilirubin as well as ALT and GGT in both men and women were not predictors of the likelihood of developing metabolic syndrome.

• Korean Journal of Veterinary Research
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• v.32 no.3
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• pp.357-364
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• 1992

Artemisia Iwayomogi Compositae) has been used clinically for jaundice, hepatitis, liver cirrhosis etc. The purposes of present study were to examine pharmacological effects of Artemisia Iwayomogi water extract(AIWE) on biochemical parameters (activities of ALP and LAP, contents of glucose, total bilirubin, total protein and albumin in serum, A/G ratio, and levels of hepatic glycogen) against hepatic injury by carbon tetrachloride($CCl_4$) in rats. The results were as follows ; 1. Increased ALP activities by $CCl_4$ were very significantly(p<0.001) decreased in AIWE posttreatment groups at 72 hours and significantly(p<0.05) decreased in AIWE pretreatment groups at 72 hours. Increased LAP activities by $CCl_4$ were significantly (p<0.05) decreased in AIWE posttreatment groups at 72 hours. A little increased total bilirubin contents by $CCl_4$ were very significantly (p<0.001) decreased in AIWE posttreatment groups at 24, 48 and 72 hours. 2. Increased glucose contents by $CCl_4$ were decreased in AIWE posttreatment groups. Decreased hepatic glycogen levels by $CCl_4$, were significantly (p<0.05) increased in AIWE posttreatment groups at 48 and 72 hours. 3. Decreased total protein contents by $CCl_4$ were significantly (p<0.05) increased in AIWE posttreatment groups at 48, 72 hours. Decreased albumin contents by $CCl_4$ were increased in proportion to numbers of AIWE treatments in AIWE pre- and posttreatement groups. Decreased A/G ratios by $CCl_4$ were significantly (p<0.05) increased in AIWE posttreatment groups at 48 hours. In conclusion, AIWE did not affect normal liver function and had hepatoprotective effects rather than direct preventive effects to $CCl_4$-induced cholestasis, damages in metabolisms of glucose, protein and bilirubin.

• YAKHAK HOEJI
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• v.54 no.4
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• pp.270-281
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• 2010

Total parenteral nutrition (TPN) is necessary to neonates in neonatal intensive care unit (NICU) for survival and growth because of impossible of enteral feeding. Long-term TPN can be associated with a broad spectrum of hepatobiliary disorder, ranging from mild hepatic dysfunction to severe end-stage liver disease. Cholestasis developed most commonly in neonate, ursodeoxycholic acid (UDCA) is widely used in adult with cholestatic and non-cholestatic liver diseases but there have been limited data on the effects in neonate with PNAC. This study was performed retrospectively to review all medical histories of the total 30 neonates with was administrated UDCA for treatment to parenteral nutrition associated cholestasis (PNAC) at Chungbuk National University Hospital NICU from April 2002 to December 2008. UDCA was administrated at bilirubin is over 2 mg/dl. The criterias for drug evaluation were included hepatic biochemical marker such as direct bilirubin, total bilirubin, AST, ALT, ALP and GGT, TPN therapy period, cholestasis development period, UDCA treatment period, UDCA dosage and adverse effect. In the results, Post-UDCA treatment significant was decreased direct bilirubin, total bilirubin, AST and ALP (p<0.05), and was decreased GGT (p>0.05) and slightly was increased ALT (p>0.05). Reffective timect biDCA was appear at mean $10.5{\pm}1.3$ days, iDCA administration period was mean $64.4{\pm}5.9$ days, cholestasis period was mean $71.9{\pm}6.4$ days and UDCA dosage was mean $22.9{\pm}0.9$ mg/kg/day. Common adverse effects is diarrhea, 5 patients arised mild diarrhea but it possible also related with increased enteral feeding. In conclusion, iDCA can decrease direct bilirubin that major parameter t bcholestasis and oher hepatic biochemical makers. UDCA is effective on PNAC without any serious side effect and cost-effective. Although no greatly shortening cholestasis period, but can protect to develop into severe liver disease and other complication or death. Based on these result, UDCA is recommended for treatment of cholestasis at direct bilirubin is over 2 mg/dl.

• The Journal of Korean Medicine
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• v.34 no.4
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• pp.46-55
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• 2013

Objectives: Classifying the pattern of jaundice during diagnosis will significantly improve the outcome of common KM interventions. This study aimed at determining an objective index for accurately diagnosing heat and dampness KM patterns in patients with jaundice. Methods: We systematically reviewed laboratory findings from case reports published in the scientific literature of Korean medicine. Cases were classified as following either the heat or dampness pattern. Biochemical indices were compared using a Bayesian factor (BF) analysis and standard t-tests. Results: The laboratory findings of 32 patients were evaluated. The heat pattern was observed in 17 patients and the dampness pattern in 15. No significant differences were observed between the 2 groups in terms of white blood cell count (BF=1.659); hemoglobin concentration (BF=2.627); platelet count (BF=1.019); or levels of direct bilirubin (BF=1.453), aspartate aminotransferase (BF=1.226), alanine aminotransferase (BF=1.340), alkaline phosphatase (BF=2.344), or gamma-glutamyl transpeptidase (BF=2.782). However, total bilirubin levels were significantly higher in the dampness pattern group (BF=0.854, P-value=0.070). Conclusions: Patients with high total bilirubin levels may predominantly follow the dampness pattern, while those with low levels may predominantly follow the heat pattern. These results are expected to be useful for the development of timely and efficient KM treatments as well as new integrative therapeutic approaches for jaundice. However, further studies are essential to fully validate the utility of total bilirubin as a biomarker for differentiating between heat and dampness patterns.

• Clinical and Experimental Pediatrics
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• v.56 no.2
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• pp.75-79
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• 2013

Purpose: It has been reported that 10% to 20% of children with Kawasaki disease (KD) will not respond to intravenous immunoglobulin (IVIG) treatment. In this study, we aimed to identify useful predictors of therapeutic failure in children with KD. Methods: We examined 309 children diagnosed with KD at the Kyungpook National University Hospital and the Inje University Busan Paik Hospital between January 2005 and June 2011. We retrospectively reviewed their medical records and analyzed multiple parameters in responders and nonresponders to IVIG. Results: Among the 309 children, 30 (9.7%) did not respond to IVIG. They had significantly higher proportion of neutrophils, and higher levels of aspartate aminotransferase, alanine aminotransferase (ALT), total bilirubin, and N-terminal fragment of B-type natriuretic peptide than did responders. IVIG-nonresponders had a significantly longer duration of hospitalization, and more frequently experienced coronary artery lesion, and sterile pyuria. No differences in the duration of fever at initial treatment or, clinical features were noted. Conclusion: Two independent predictors (ALT${\geq}$84 IU/L, total bilirubin${\geq}$0.9 mg/dL) for nonresponse were confirmed through multivariate logistic regression analysis. Thus elevated ALT and total bilirubin levels might be useful in predicting nonresponse to IVIG therapy in children with KD.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.2 no.1
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• pp.59-64
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• 1999

Purpose: The aims of this study are to measure the serum levels of fat soluble vitamins (vitamin A and D) from bile duct ligated rats, and to evaluate the effect of oral bile acids administration to facilitate absorption of fat soluble vitamins. Methods: We measured serum ALT, total bilirubin, vitamin A, and vitamin D of Sprague-Dawley rats 1 week before and 4 weeks after experimental bile duct ligation. Rats were consisted with 3 groups. Group 2 had been fed bile acids and group 3 ursodeoxycholic acid after operation for 4 weeks. Multi-vitamin was given to all groups. Results: 1) Base line (mean value before duct ligation): ALT 74.2 IU, total bilirubin 0.26 mg/dL; vitamin D 13.01 ng/mL vitamin A $0.87\;{\mu}g/mL$, total bile acids $25.16\;{\mu}mol/L$. 2) Four weeks after ligation: ALT 100.7 IU, total bilirubin 2.58 mg/dL; vitamin D 7.89 ng/mL vitamin A $1.37{\mu}g/mL$, total bile acids $278.22\;{\mu}mol/L$. 3) 4 weeks after ligation, each group (group 1, group 2 and group 3) showed vitamin D (7.62, 8.10 and 7.99) ng/mL, vitamin A (1.68, 1.06 and 1.33) ${\mu}g/mL$, total bile acids (233.17, 345.80 and 268.57) ${\mu}mol/L$, which were statistically not significant. Conclusion: Serum level of vitamin A is increased after bile duct ligation although vitamin D is decreased. Oral administration of bile acids does not affect the serum levels of vitamin A and D in bile duct ligated rats.

• Pediatric Gastroenterology, Hepatology & Nutrition
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• v.5 no.1
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• pp.51-61
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• 2002

Purpose: The most common causes of neonatal cholestasis are neonatal hepatitis (NH) and extrahepatic biliary atresia (EHBA). Since neonatal cholestasis presents with variable expression of same pathologic process and has similar clinical, biochemical, and histologic features between EHBA and idiopathic neonatal hepatitis (NH), differential diagnosis is often difficult. We reviewed the differences of clinical characteristics and laboratory data to find out any correlation between the results of $Tc^{99m}$ DISIDA scan and presence of acholic stool. Methods: Between June 1993 and January 2001, total 29 infants younger than 4 month-old underwent $Tc^{99m}$ DISIDA scan. Their biochemical tests and clinical course were reviewed retrospectively. Results: Patients who had negative intestinal activity on $Tc^{99m}$ DISIDA scan showed acholic stool and revealed higher serum direct bilirubin and urine bilirubin level. 18.2% of patients with acholic stool showed intestinal activity on $Tc^{99m}$ DISIDA scan and 81.8% of them did not. All the patients without acholic stool showed positive intestinal activity on $Tc^{99m}$ DISIDA scan. The result of $Tc^{99m}$ DISIDA scan and the presence of acholic stool showed high negative correlation (r :-0.858). Patients with acholic stool and negative intestinal activity on $Tc^{99m}$ DISIDA scan showed higher serum total bilirubin level. Patients without acholic stool and positive intestinal activity on $Tc^{99m}$ DISIDA scan showed higher serum level of ALT. Conclusion: Patients with acholic stool and negative intestinal activity showed high correlation, but 18.2% of patients with acholic stool showed positive intestinal activity. So operative cholangiogram or transcutaneous liver biopsy should be performed for confirmation.